Evidence
Alert

Home oxygen therapy prescribed for 15 hours a day did not reduce breathlessness at six months and is hard to take for people with severe chronic heart failure

This NIHR-funded trial found no evidence that long-term home oxygen therapy improves symptoms or quality of life for people with severe chronic heart failure. There were encouraging signs after three months but these were not sustained at six months by which time there was no difference between the oxygen therapy group, who continued to receive ...

Alert

Heated, humidified high-flow oxygen therapy may be a useful alternative to other forms of respiratory support for preterm babies

This review found that heated, humidified high-flow oxygen therapy by nose was a safe and effective alternative to other non-invasive methods for supporting breathing for preterm babies. It was less likely to cause nasal injury compared with other methods that used nose tubes. Oxygen therapy is commonly used as a form of breathing support for ...

Alert

Less stringent target oxygen levels for acute bronchiolitis are safe and effective

This NIHR-funded trial found that acute bronchiolitis in children can be safely managed to a slightly lower target level of oxygen saturation than currently used. Setting the level at which children might be taken off oxygen or allowed home at 90% or more led to resolution of cough in 15 days. Time to resolution of ...

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New evidence available on corticosteroids added to antibiotics in severe pneumonia

For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial. The evidence was less supportive of using corticosteroids in people with less severe pneumonia. Results showed modest benefits in allowing patients to reach a clinically stable recovery and leave hospital an average of ...

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Rapid tests for diagnosing drug resistant tuberculosis are accurate and may be cost effective

This NIHR funded systematic review and economic evaluation found that three rapid tests for diagnosing drug resistant tuberculosis were highly accurate and likely to be cost effective in the UK. These tests produce results within one day of obtaining a sample. This is a significant reduction compared with the standard tests which can take about ...

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Inhaling a saline mist did not reduce the time in hospital for babies with bronchiolitis

In this NIHR-funded trial babies with a viral chest infection (acute bronchiolitis) were treated either with a strong saline mist (nebulised 3% hypertonic sodium chloride) with standard care or standard care alone. The stronger than usual, hypertonic saline mist had no effect on the time it took for babies to be ready for discharge, nor ...

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Continuous positive airway pressure led to less daytime sleepiness in older adults with sleep apnoea

This NIHR trial found that continuous positive airway pressure for obstructive sleep apnoea in people aged 65 and over led to less daytime sleepiness and was reasonable value for money. Obstructive sleep apnoea causes the airway to close intermittently overnight leading to daytime sleepiness. It is most common in older people, but previous studies have ...

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Pre-hospital non-invasive ventilation for people with acute respiratory failure

This NIHR-funded systematic review and cost-effectiveness study found that pre-hospital (i.e. in the ambulance) non-invasive ventilation in the form of continuous positive airway pressure for people with acute respiratory failure, can reduce both the risk of dying and the need for ventilation in intensive care. The small device used by trained ambulance personnel was more ...

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Interventions that help and harm patients in the critical care unit

This systematic review and expert consensus process found 15 non-surgical interventions affecting adult mortality in critical care. Seven interventions, such as the use of tranexamic acid after severe blood loss, reduced deaths. Eight interventions, such as improving oxygen supply by using a drug, dobutamine, increased them. 2015 UK guidelines only partly reflect these findings. They ...

Alert

Pulmonary rehabilitation improves quality of life and exercise capacity

This Cochrane systematic review found that pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD) improved quality of life and exercise capacity compared to usual care. It also relieved shortness of breath and fatigue. This updated review provides stronger evidence to support NICE's recommendation that pulmonary rehabilitation should be available to everyone who is ...

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